Low back pain

Low Back Pain Facts

Low back pain is a common ailment which most people (80-85%) suffer with it at some time in their lives. The causes of low back pain are poorly understood and can range from trauma, poor lifting and overuse/underuse of the muscles. 85% of the time the pain is mechanical coming from either the muscles, joints or ligaments. Fortunately, it is rare for the pain to be caused by a serious medical problem and such causes can be ruled out by a thorough history and examination from your healthcare provider.





When should I see a doctor?

Often low back pain episodes will get better on there own as nature takes its course. It’s important to stay as active as possible as the old adage of bed rest and trying to completely avoid pain is not the best advice. Most people do just fine by staying active, coping the best they can, and modifying daily activities as to not re-agitate the tender tissues.

You should see a doctor when the pain is too much for you to cope with or there are specific activities important to you that you are having difficult undertaking. Understand that low back pain is a very common problem and the chances that it is caused by serious disease are very rare. Health practitioners can help suggest possible ways to control your pain and advise you of ways to deal with the pain and get on with your life. It is normal to worry about the cause of your low back pain and the impact it may have on your life. Talking with your healthcare provider about these worries and concerns can be helpful. You will usually find there is no serious cause of the pain and that there are ways to relieve the symptoms and get you back to your normal activities.

Make sure you work with your healthcare provider to find ways to better manage and control the low back pain.

What can I do for myself?

Keep in mind that staying active with your normal activities is the best thing you can do to limit the effects of low back pain on your life. You may have to modify the way you perform certain activities to keep from aggravating the tender tissues. Examples may be how you bend over to pick something up, getting off a chair or toilet, putting on your shoes or pants, sitting too long at work. Pain medication, hot/cold packs, massage, manipulation and other modalities may offer pain relief, but they are best used to getting you re-activated and moving on with your life. Keep in mind that the pain is your own and the manner in how you deal with it and return to normal activities is the greatest thing you can do for yourself. Try to stay working as only in cases of particularly severe pain do you need to be off work. You may need to find restricted duties or reduced hours, but staying active is important. Staying active helps prevent long-term problems. If it has been several weeks since you have been back to work, you really should be planning with your doctor or therapist and employer how and when you can return. Here are some ideas to keep your low back pain from becoming a more long-term problem:

•Keep moving.

•Do not stay in a position for too long.


•Move before you stiffen up.


•Move a little more each day.

•Don’t stop doing things-just change the way you go about doing them.


Ways to increase your activity.


First ask what is it that I want to do? Is it walking further, going up stairs, shopping, etc.? Find out how long you can perform this activity without “flaring-up” your condition or making you worse off than when you started. This is individual to you. Reduce the amount or time of activity by 20% so you’re able to perform the activity, but it does not take you to the “flare up” point. Having a little discomfort is alright, though the duration of the activity should not make you worse off than before. Gradually increase the activity little by little, as not to reach the “flare-up” state. Slowly you will notice you’re able to do the activity longer without “flaring-up” the condition. Don’t be too upset if you have a “flare-up,” just reassess your activity level and continue on. It’s normal to have good days and bad days. It takes some patience, but it works.


Ways to Modify Your Activities

Sitting

Find a chair that is comfortable to you and supports the small of your back, you may have to experiment with several. Get up and stretch often.


Rising from a chair
Avoid slumping as in the left hand picture. Instead stick your chest out as in the right hand picture to protect your back. Getting up and down like this utilizes what is called “the hip hinge” to spare your spine. This can be incorporated in other lifting and bending activities as well.



Desk work
Make sure the height of the chair fits the desk. Arrange the keyboard monitor and phone so you do not feel strained. Get up and stretch often.

Driving
Adjust your seat from time to time. Try some support in the small of the back. Take regular stops and get out of the car for a quick break. Walk around and stretch.

Lifting
Think before you lift on the best way to move the load. Don’t lift more than you need to. Keep the load close to your body. Lightly tighten your stomach muscles to brace your back. Turn with your feet when carrying the load, don’t twist the back. Finally, be sure to “hip hinge” to maintain an upright spine as the picture above shows.

Carrying and shopping
Ask yourself if you need to carry at all. Keep the load close to your body. Split the weight of the load between two hands. Push carts with both hands.

Daily activities/hobbies
Don’t do any one thing for too long. Keep changing activities.

Sports
Continuing to play your normal sports is fine, but you may need to modify your game or decrease your intensity.

Sleeping
Some people find relief sleeping of a firmer mattress; possibly try a sheet of chipboard under the mattress. Painkillers an hour before you go to bed may help.

Sex
Sex is fine, but you may need to try different positions.

If your pain is not settling down or getting worse, you may need further assessment from your health care provider. Make sure you ask questions or voice your concerns about your pain to your healthcare provider.


Rehabilitation

If there are specific activities which you are having difficulty with, a rehabilitation specialist can help. Once serious causes are ruled out and the pain is under control, the rehab specialist examines where the dysfunction lies. First identify specific goals or limitations you wish to overcome that are agreed upon by both the practitioner and you. The rehab specialist will perform a functional evaluation to determine what you are able to do and what areas may be causing some trouble. Bridging the gap between what you are able to do and what you want to do is the essence of rehabilitation. This may consist of specific exercises prescription that helps improve areas where you are having some difficulty. Make sure and voice your thoughts and concerns with your healthcare provider. Pain and “flare-ups” may happen from time to time. This is normal and should not be the focus in care. Rather, try to focus on the exercises that are bridging the gap to your goals and what activities you want to do.

It is important that you maintain contact with your healthcare provider. If the pain is not settling down or is getting worse, you may need further assessment. Follow up visits provide you the opportunity to obtain more information and address any fears or concerns you may have with your low back pain.

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